Pica behavior is prevalent and associated with low iron status in pregnant adolescents

Abstract

A relationship between iron deficiency, pregnancy, and pica (the craving and purposive consumption of non‐food items) has been frequently observed. However, few studies have related pica behaviors to biomarkers of iron status, and little is known about pica prevalence in pregnant adolescents. To address this, we undertook a longitudinal study examining iron status and pica behaviors among a group of 158 pregnant adolescents (≤ 18 y). Approximately two‐thirds of the participants were African American and 25% were Hispanic. Maternal iron status [hemoglobin (Hb), transferrin receptor (TfR), serum ferritin (SF), total body iron (TBI), and hepcidin (Hep)] was assessed at mid‐gestation (~26 weeks) and delivery. Pica and other characteristics were assessed up to three times across gestation. Among the 158 adolescents, 45% reported engaging in pica at some point during pregnancy. Substances ingested included ice, starches, powder, and plastic. At mid‐gestation, mean SF, TBI, and Hep values in the pica group were significantly lower (p<0.05) than those in the non‐pica group. The prevalence of anemia (Hb≤10.5 g/dL) at mid‐gestation was significantly higher (p<0.002) in the pica group (27.8%) than among those who did not report pica (6.5%). While further studies must address the etiology of these relationships, our findings suggest that pica could be an inexpensive method for screening for iron deficiency.Grant Funding Source: USDA 2005–35200 and 2008–01857